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J Med Oncl Ther 2017 | Volume 2 Issue 4
allied
academies
Oncology and Biomarkers Summit
November 27-28, 2017 | Atlanta, USA
Annual Congress on
A
bimodal pattern of hazard of relapse among early stage
breast cancer patients has been identified in multiple
databases from US, Europe and Asia. We are studying these
data to determine if this can lead to new ideas on how to
prevent relapse in breast cancer. Using computer simulation
and access to a very high quality database from Milan for
patients treated with mastectomy only, we proposed that
relapses within 3 years of surgery are stimulated somehow
by the surgical procedure. Most relapses in breast cancer
are in this early category. Retrospective data from a Brussels
anesthesiology group suggests a plausible mechanism. Use
of ketorolac, a common NSAID analgesic used in surgery
was associated with far superior disease-free survival in the
first five years after surgery. The expected prominent early
relapse events in months 9-18 are reduced 5-fold. Transient
systemic inflammation accompanying surgery (identified by
IL-6 in serum) could facilitate angiogenesis of dormant micro-
metastases, proliferation of dormant single cells, and seeding
of circulating cancer stem cells (perhaps in part released from
bone marrow) resulting in early relapse and could have been
effectively blocked by the perioperative anti-inflammatory
agent. If this observation holds up to further scrutiny, it
could mean that the simple use of this safe, inexpensive and
effective anti-inflammatory agent at surgery might eliminate
early relapses. We suggest this would be most effective for
triple negative breast cancer and be especially valuable in
low and middle income countries. Similar bimodal patterns
have been identified in other cancers suggesting a general
effect.
Speaker Biography
Michael Retsky (PhD in Physics from University of Chicago) made a career change to
cancer research 30 years ago. He is on Staff Member at Harvard TH Chan School of
Public Health and Faculty at University College London. He was on Judah Folkman’s
Staff at Harvard Medical School for 12 years. He is Editor of a Nature/Springer book on
the breast cancer project published July 2017. He was the first person to use what is
now called metronomic adjuvant chemotherapy and is a founder and for 10 years was
on the Board of Directors of the Colon Cancer Alliance. He has published more than 60
papers in physics and cancer.
e:
mretsky@hsph.harvard.eduMichael Retsky
Harvard TH Chan School of Public Health, USA
Perioperative use of NSAID might prevent early relapses in breast and other
cancers: An upstream approach